Ready or not, health law outreach training begins

CHICAGO (AP) — It wasn't easy writing the training program for the 800 outreach workers who will help Illinoisans sign up for insurance under President Barack Obama's health law.

Washington was still shaping the regulations. Illinois lawmakers were still amending bills. Then the Obama administration delayed part of the law affecting some businesses. Every change meant more revisions.

All the moving parts made it a challenge, but so far everyone who has taken the course has passed the test required for certification, said Elizabeth Calhoun, a University of Illinois at Chicago professor who led the effort under a $910,000 contract between the university and the state.

"I think they're going to be ready," said Calhoun, UIC professor of health policy and administration. "We've been able to roll with the punches."

The outreach workers — called "in-person counselors" by Illinois officials — will help uninsured people find out about new benefits available to them and walk them through the process of enrolling for coverage beginning Oct. 1. Since they'll be on the front lines, their training is crucial to the health law's success in the state.

But the training program still faces a number of obstacles that raise questions about how prepared trainees will be to enroll hundreds of thousands of Illinois residents in new coverage options.

They are expected to learn the rules for buying subsidized insurance coverage through a new website that isn't up and running yet. They need to fathom intricate eligibility requirements for Medicaid, All Kids and other state public benefits programs. What's more, they're required to complete a federal training program that isn't ready.

The Illinois training program presents a daunting amount of material in three days — a one-day online portion and two more days of training in person.

"It is a lot of information, especially if you're not acquainted with the world of insurance and don't know Medicaid too well," said 23-year-old Manuel Espitia, a Princeton University history graduate who was among the first to complete the Illinois training. "It is a lot to absorb."

Espitia said his fellow trainees had some unanswered questions, but were told they would get updates later. They left with a reference manual, he said, and optimism.

"I think everyone went out feeling good, with a really good idea of how we're going to do this," said Espitia, who earns $12 an hour doing outreach work for Chicago-based Access Community Health Network. "This is so fresh and so new, we're working through it. I think there are going to be a lot of bumps in the road, but all the questions will be answered as we go along."

But not every trainee will be a Princeton graduate like Espitia. In fact, many of the job ads posted by the grantee agencies say applicants need only high school diplomas or GEDs.

The Associated Press reviewed the online portion of the Illinois training program and found difficult, college-level vocabulary. A consultant who specializes in readability analyzed four sample passages at the request of the AP and judged them "too difficult," saying the high-level text may be tough for trainees with high school diplomas, GEDs and no college educations.

"But these passages will also be off-putting to those with college degrees," Portland, Ore.-based communications consultant Ann Wylie said in an email.

She recommended shorter words and sentences, writing directly to the reader and "writing about people doing things instead of about programs and procedures."

UIC's Calhoun said difficult vocabulary is hard to avoid when you're talking about health insurance and Medicaid eligibility. "Obviously there are some words and some areas that are going to be above a high school level," she said.

Calhoun said the two days of in-person training, not reviewed by AP, will clarify lessons with role-playing exercises and worksheets. Trainers will walk through scenarios using hypothetical families, which may make some complicated ideas easier to grasp.

The AP review also turned up a factual error in the online materials: Audio of the online training incorrectly said Illinois law requires the in-person counselors to be licensed. They must be certified, but a licensure requirement was dropped before the bill passed the Legislature.

Calhoun said the mistake was made because of the legislative change, and would be corrected by UIC.

Training also emphasizes security and privacy standards. The trainees are cautioned not to discuss consumers' personal information in hallways, elevators and cafeterias where it could be overheard. They are trained to lock their computers every time they step away from them.

They're also told they'll be required to use reporting tools to gather information on uninsured Illinoisans for the state on a regular basis "as requested by grants managers, regional outreach coordinators and other state staff." Illinois plans to use this data to track the progress of the outreach.

Training will be ongoing, with web-based seminars planned for the workers, Calhoun said. There will be oversight from state coordinators who will monitor how the workers are doing.

"I hope this is an opportunity to improve the health of communities," Calhoun said. "It is gratifying to be part of it."